Return to work following mild traumatic brain injury: Psychological and cognitive factors in a litigating sample in the post acute stage of recovery.

The purpose of this study was to investigate return to work (RTW) rates following a single uncomplicated mild Traumatic Brain Injury (mTBI) in the post-acute stage in the context of active litigation. More specifically, we sought to determine what psychological and/or cognitive factors predict a RTW after mTBI. Archival data were obtained from a random sample of litigating patients (n = 125; 54% female; mean age: 42.96 (SD = 12.74) who were referred to a private practice for a neuropsychological examination regarding their disability status following a single uncomplicated mTBI. A hierarchical regression analysis was used to assess the predictive value of emotional symptoms and cognition with respect to RTW status. Approximately 50% of the sample did not RTW. Attentional deficits (rs = -0.248) and depressive symptoms (rs = 0.248) were significantly associated with RTW. A hierarchical regression analysis found that depressive symptoms (p < .05) were associated with RTW outcomes. These findings suggest that individuals with increased depressive symptoms are more likely to demonstrate poor RTW outcomes in the post-acute stages of mTBI. These results are of interest to clinicians as they underscore the importance of screening and early intervention for depressive symptoms following a single uncomplicated mTBI in the post-acute stages in litigating samples.

The effect of diagnostic terminology on cognitive, emotional, and post-concussive sequelae following mild brain injury.

OBJECTIVE: We sought to determine whether the diagnostic terms 'mild traumatic brain injury (mTBI)' and 'concussion' result in differences in perceived cognitive, emotional, and post-concussive sequelae. METHOD: A total of 81 healthy university students (79% female; 69% of Asian descent) were randomly assigned to one of two conditions: mTBI (n = 41), or concussion (n = 40), and were instructed to simulate on a battery of cognitive (Neuropsychological Assessment Battery - Screening Module), emotional (Beck Anxiety Inventory, Beck Depression Inventory-II), and post-concussive (Rivermead Postconcussive Symptoms Questionnaire) measures. RESULTS: There were no significant group differences between expected cognitive, emotional, or post-concussive consequences. However, both groups received poorer scores than the normative data. CONCLUSIONS: These results suggest that diagnostic terminology does not appear to influence anticipated recovery following mild brain injury. However, the presentation of information about the injury itself may impact recovery outcomes. This study provides preliminary support for the potential negative effects that may arise as a result of providing participants with non-evidence based information about mild brain injuries.

On the nature of objective and perceived cognitive impairments in depressive symptoms and real-world functioning in young adults.

Cognitive impairments in depression contribute to disability. According to prevailing cognitive theories, one's perception related to cognitive ability can cause and maintain depression, and related outcomes. Here, we investigate the degree to which perceived cognitive impairment predicts functional impairment above and beyond objective neurocognition. A sample of young adults (n = 123) completed a battery of tests measuring objective cognitive ability, perceived cognitive function (e.g., Perceived Deficits Questionnaire), disability (e.g., World Health Organization Disability Assessment Schedule) and depressive symptoms (Beck Depression Inventory-2). Hierarchical multiple regression analyses tested the incremental variance that perceived cognitive impairment accounts for above and beyond neuropsychological test measures and disability related to depression. Results show that perceived cognitive impairment accounts for significant incremental variance in depressive symptoms beyond neuropsychological test scores; disability measures were significantly associated with depressive symptoms, as was perceived cognitive impairment. Individuals with depression and related disorders are more likely to report cognitive impairments and experience diminished cognitive ability - relative to healthy controls - regardless of objective impairments, highlighting the importance of considering, measuring, and treating this perceived cognitive impairment, that is, Cognitive Impairment Bias (Dhillon and Zakzanis, 2019).

Development and validation of an Overreporting Scale for the Personality Inventory for DSM-5 (PID-5).

Our aim in the current study was to develop a validity scale for the Personality Inventory for DSM-5 (PID-5) to detect noncredible overreported responding. To this end, we used a rare symptoms approach and identified extreme response options on PID-5 items that were infrequently endorsed by students in 3 different university samples (N = 1,370) and in a psychiatric patient sample (N = 194). The resulting 10-item scale (the PID-5-ORS) produced adequate-to-good estimates of internal reliability and was significantly correlated with the Minnesota Multiphasic Personality Inventory-2 Restructued Form (MMPI-2-RF) overreporting validity scales, providing evidence of concurrent validity. The criterion validity of the PID-5-ORS was demonstrated in an analog simulation design study. More specifically, university students instructed to overreport (n = 80) scored substantially higher on the PID-5-ORS relative to both a group of genuine psychiatric patients and students instructed to complete the PID-5 under standard (honest) instructions (n = 161); the effect size magnitudes associated with these differences were large. Classification accuracy analyses further revealed that high scores on the PID-5-ORS were associated with high specificity (and thus, low rates of false positive classifications) in differentiating overreporters from genuine patients, with sensitivity being somewhat weaker. (PsycINFO Database Record

The impact of underreporting and overreporting on the validity of the Personality Inventory for DSM-5 (PID-5): A simulation analog design investigation.

The Personality Inventory for DSM-5 (PID-5) is a 220-item self-report instrument that assesses the alternative model of personality psychopathology in Section III (Emerging Measures and Models) of DSM-5. Despite its relatively recent introduction, the PID-5 has generated an impressive accumulation of studies examining its psychometric properties, and the instrument is also already widely and frequently used in research studies. Although the PID-5 is psychometrically sound overall, reviews of this instrument express concern that this scale does not possess validity scales to detect invalidating levels of response bias, such as underreporting and overreporting. McGee Ng et al. (2016), using a "known-groups" (partial) criterion design, demonstrated that both underreporting and overreporting grossly affect mean scores on PID-5 scales. In the current investigation, we replicate these findings using an analog simulation design. An important extension to this replication study was the finding that the construct validity of the PID-5 was also significantly compromised by response bias, with statistically significant attenuation noted in validity coefficients of the PID-5 domain scales with scales from other instruments measuring congruent constructs. This attenuation was found for underreporting and overreporting bias. We believe there is a need to develop validity scales to screen for data-distorting response bias in research contexts and in clinical assessments where response bias is likely or otherwise suspected. (PsycINFO Database Record

The Effect of Response Bias on the Personality Inventory for DSM-5 (PID-5).

Valid self-report assessment of psychopathology relies on accurate and credible responses to test questions. There are some individuals who, in certain assessment contexts, cannot or choose not to answer in a manner typically representative of their traits or symptoms. This is referred to, most broadly, as test response bias. In this investigation, we explore the effect of response bias on the Personality Inventory for DSM-5 (PID-5; Krueger, Derringer, Markon, Watson, & Skodol, 2013 ), a self-report instrument designed to assess the pathological personality traits used to inform diagnosis of the personality disorders in Section III of DSM-5. A set of Minnesota Multiphasic Personality Inventory Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008 / 2011 ) validity scales, which are used to assess and identify response bias, were employed to identify individuals who engaged in either noncredible overreporting (OR) or underreporting (UR), or who were deemed to be reporting or responding to the items in a "credible" manner-credible responding (CR). A total of 2,022 research participants (1,587 students, 435 psychiatric patients) completed the MMPI-2-RF and PID-5; following protocol screening, these participants were classified into OR, UR, or CR response groups based on MMPI-2-RF validity scale scores. Groups of students and patients in the OR group scored significantly higher on the PID-5 than those students and patients in the CR group, whereas those in the UR group scored significantly lower than those in the CR group. Although future research is needed to explore the effects of response bias on the PID-5, results from this investigation provide initial evidence suggesting that response bias influences scale elevations on this instrument.

Multivariate fMRI and Eye Tracking Reveal Differential Effects of Visual Interference on Recognition Memory Judgments for Objects and Scenes.

Recent work has demonstrated that the perirhinal cortex (PRC) supports conjunctive object representations that aid object recognition memory following visual object interference. It is unclear, however, how these representations interact with other brain regions implicated in mnemonic retrieval and how congruent and incongruent interference influences the processing of targets and foils during object recognition. To address this, multivariate partial least squares was applied to fMRI data acquired during an interference match-to-sample task, in which participants made object or scene recognition judgments after object or scene interference. This revealed a pattern of activity sensitive to object recognition following congruent (i.e., object) interference that included PRC, prefrontal, and parietal regions. Moreover, functional connectivity analysis revealed a common pattern of PRC connectivity across interference and recognition conditions. Examination of eye movements during the same task in a separate study revealed that participants gazed more at targets than foils during correct object recognition decisions, regardless of interference congruency. By contrast, participants viewed foils more than targets for incorrect object memory judgments, but only after congruent interference. Our findings suggest that congruent interference makes object foils appear familiar and that a network of regions, including PRC, is recruited to overcome the effects of interference.